Provider Demographics
NPI:1083711139
Name:GARFUNKEL, LYNN CARLA (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:CARLA
Last Name:GARFUNKEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1425 PORTLAND AVE
Mailing Address - Street 2:BOX 238
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3001
Mailing Address - Country:US
Mailing Address - Phone:585-922-2575
Mailing Address - Fax:585-922-3929
Practice Address - Street 1:1425 PORTLAND AVE
Practice Address - Street 2:BOX 238
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3001
Practice Address - Country:US
Practice Address - Phone:585-922-2575
Practice Address - Fax:525-922-3929
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY182048208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01196616Medicaid
NYJ400042956Medicare PIN